Individual
MARK ROSENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 ALBANY AVE, ALBANY, MN 56307-9328
(320) 339-0474
Mailing address
820 ALBANY AVE, ALBANY, MN 56307-9328
(320) 339-0474
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
Z996251476524
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
384666
STS
MN
Enumeration date
08/02/2023
Last updated
08/09/2023
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